The objective of this project is to investigate the utilization and efficacy of Dominican herbal medicine in New York City and the Dominican Republic. Studies have shown that parallel health care delivery systems involving herbal remedies and traditional healers exist within immigrant communities in urban settings, particularly among Hispanics. This has been documented among Dominicans who constitute the largest Hispanic immigrant group in New York City according to the 2000 US Census Report. Research into their ethnomedical traditions and practices can provide more culturally sensitive methods for handling diverse patient populations and contribute to improving the overall effectiveness of public health care in the US. In order to evaluate the botanical treatments used in Dominican traditional medicine, an integrative, multidisciplinary approach will be utilized that incorporates biology, chemistry, clinical medicine, ethnobotany, ethnomedicine, and public health. This project will be accomplished through the following steps: (1) conduct surveys among Dominicans in New York City and in the Dominican Republic to identify the most commonly used herbal remedies for selected health conditions; (2) analyze differences and similarities in the use of these remedies between Dominican populations in New York City and the Dominican Republic; (3) investigate the known pharmacology and chemistry of the most frequently used plants based on a review of the literature; (4) develop a list of botanical therapies deserving of further investigation for anti-inflammatory properties based on an evaluation of the status of biological and clinical knowledge about the plant, its importance to the Dominican pharmacopoeia, safety of its known or presumed constituents, efficacy, conservation status, and potential for sustainable production; and (5) test these botanicals using two in-vitro assays to measure anti-inflammatory activity, isolate/characterize anti-inflammatory components for purposes of standardization, and make recommendations for future clinical studies. The health conditions to be studied include the following: asthma, dermatological conditions, diabetes, diarrhea, musculoskeletal pain, reproductive/gender-specific disorders, and respiratory infections. These medical problems have been selected based on (a) their prevalence in the [unreadable] Dominican community, (b) the use of traditional remedies for their treatment, as well as, for some, (c) the role of inflammation in the condition's etiology. Inflammation is an important component of the pathophysiology of many health conditions. As such, an investigation into the clinically relevant, biological activities exhibited by traditionally used plants should reveal those that exhibit anti-inflammatory properties and may increase understanding of their efficacy in traditional use. The proposed project will be conducted by an international, multidisciplinary, and multicultural collaborative research team consisting of scientists, students, trainees, and assistants from four collaborating institutions in the United States and two in the Dominican Republic. The collaborative approach and results from this R21 project will enable preparation of an R01 proposal. [unreadable] [unreadable]